Mpox

Summary

• Mpox (previously known as monkeypox) is a rare but potentially serious viral disease.
• Mpox does not easily spread between people. It usually requires very close contact or contact with contaminated surfaces or items.
• Until 2022, mpox was mostly limited to endemic countries in Central and West Africa.
• From May 2022, there have been cases of mpox in other countries, including Australia.
• There has been an increase of cases in Australia in 2024. Most cases have been acquired in Australia and a small number have been in people who were fully vaccinated.
• Individuals at greater risk should be fully vaccinated and aware of the symptoms and the risk of mpox.
• Vaccination against mpox is safe and effective in preventing severe disease.
• Vaccination appointments are currently available in Tasmania.
• If you develop mpox symptoms or are concerned you had contact with someone with mpox, please seek medical care. Call ahead to make sure you can be isolated away from others and make sure you wear a mask when attending the clinic or hospital.
• On 14 August 2024, the World Health Organization declared a new mpox outbreak in central and eastern Africa a public health emergency of international concern. More information about this outbreak is below: What is the concern for people travelling overseas?

What are the symptoms?

Symptoms of mpox infection can include any of the following:

• a distinctive rash or sores (bumps that turn into pimples, blisters or sores, and may burst to form ulcers or scabs)
• swollen lymph nodes (glands)
• fever
• headache
• muscle aches
• joint pain
• back pain
• chills
• exhaustion.

Some people only experience the rash and sores, which can vary in size and number. 

The rash or sores can occur anywhere on the body, but most often the genitals, anus, buttock or groin; less often the face, inside the mouth, palms of hands and soles of feet.

Symptoms may begin 3 to 21 days after exposure to the virus. 

Symptoms typically last for 2-4 weeks. Mpox illness is most often mild, however, some people may develop severe illness and require hospitalisation. Children, pregnant women, and immunocompromised people are at higher risk of developing severe disease. 

You should seek medical advice straight away if you develop any of these symptoms.

For full details go to www.health.gov.au/diseases/monkeypox-mpox

How does mpox spread?

Transmission between people can occur through:

• close contact with rashes, blisters or sores on the skin
• body fluids, including respiratory droplets from coughing or sneezing
• contaminated objects such as linen and towels.

A person with mpox is infectious from the time they develop any symptoms until all scabs have healed and a fresh layer of skin has formed.  This may take several weeks. Those at risk should be fully vaccinated and aware of the symptoms. 

If you develop any of the symptoms above, seek medical help straight away.

In recent outbreaks, those most at risk have been gay, bisexual and other men who have sex with men, and anyone who has been in close and prolonged intimate contact with someone with mpox. 

To find out more go to www.health.gov.au/diseases/monkeypox-mpox

Getting tested

Mpox is confirmed by laboratory testing.

If you think you may be infected, seek medical advice straight away.

Wear a face mask and call ahead to let the health service know you are concerned about mpox. 

Clinical history and examination may lead a doctor to suspect mpox. The diagnosis can be confirmed in a laboratory by testing a swab of the rash or sores.

Vaccination

The mpox vaccine available in Australia is called JYNNEOS. It is safe to use for all eligible people, including those who are immunocompromised and people living with HIV.

When to get mpox vaccine

Vaccination with JYNNEOS can be before or after exposure to mpox. Vaccination is highly effective in preventing severe illness.

The best time for people to get the vaccine is before they are exposed to mpox.  

Eligibility for vaccine:

After exposure to mpox

It is recommended that people who have already been exposed to mpox get a vaccination within 4 days of their exposure. Though less than ideal, vaccination can be given up to 14 days after exposure.

Before exposure to mpox

Vaccine is currently available for free in Tasmania and recommended for at-risk eligible persons, including:

• all sexually active gay, bisexual, non-binary people assigned male at birth, trans people, and other men who have sex with men (including with cis and trans men)
• sexual partners of the people above
• sex workers
• vaccination may also be considered for health care workers at risk of exposure to patients with mpox, subject to a risk assessment by the Communicable Diseases Prevention Unit (CDPU), including health care workers who will be caring for patients in countries affected by outbreaks, such as central and eastern Africa.

Two doses are required for best protection and are given at least 28 days apart. A booster is not currently recommended for people who are fully vaccinated (have received two doses at least 28 days apart).

Mpox vaccine can be given at the same time as most other vaccines. If you’ve been vaccinated against COVID-19 in the last 4 weeks, check with your health care provider first to see if you need to wait before you’re vaccinated against mpox.

Should I get vaccinated before travel?

Mpox vaccination is recommended for people who are already eligible for mpox vaccination in Tasmania (see above ‘Before exposure to mpox’). 

Mpox is not recommended as a routine travel vaccination.

To find out more see What is the concern for people travelling overseas?

Where to get mpox vaccine

Free and confidential mpox vaccination appointments are available through sexual health services for eligible people in Tasmania. Call ahead to check whether mpox vaccine is available. 

Alternatively for more information, or to speak to someone about mpox vaccination, call the Public Health Hotline on 
1800 671 738 (option 4) to speak with the Immunisation Team in CDPU.

What should I do if I have contact with someone who has mpox?

If you have had contact with someone who has mpox, please call the Public Health Hotline on 1800 671 738 (option 4) to speak to a Communicable Diseases Clinical Nurse Consultant.

You should avoid contact with others, wear a face mask outside your home or in your home if you cannot isolate from people you live with and wash hands or use hand sanitiser.

If you have symptoms and need to seek medical help, wear a mask and call ahead to say you are worried about mpox.

What should I do if I develop symptoms?

If you develop mpox symptoms, and particularly if you develop a rash and a fever and swollen lymph nodes, you should immediately seek medical care. 

• Call your GP or hospital to let them know you will be attending and have concerns about mpox. 
• If you have a rash or blisters, make sure these are covered by clothing and dressings. 
• Avoid close contact with others, including sexual activity.
• Wear a mask when outside your home or in your home if you can’t isolate from others in your home. 
• Be very careful with hygiene including washing hands with soap and water or using an alcohol-based sanitiser.

Where to get help

• In an emergency call ‘000’ (triple zero) for an ambulance.
• You can also present to the emergency department of your nearest hospital. Wear a face mask and call ahead to say you may have mpox.
• You can contact your General Practitioner or Sexual Health Services for testing and care.
• For other queries, contact the Communicable Diseases Prevention Unit (CDPU) on 1800 671 738 (option 4 to speak to a Communicable Diseases Clinical Nurse Consultant).
• For more information go to www.health.gov.au/diseases/monkeypox-mpox

Information for Clinicians

Clinicians should test for mpox in all patients presenting with compatible symptoms, in particular those presenting with a genital rash, lesions, or proctitis.

Clinicians should also consider the possibility of alternative diagnoses such as measles, chickenpox or shingles, Herpes Simplex infection, and syphilis.

Testing for mpox requires approval from the Communicable Diseases Prevention Unit (CDPU) in Public Health Services. This is to provide advice to clinicians regarding specimen collection and to enable the CDPU to support contact management of suspected cases.

If you suspect mpox, isolate the patient and implement standard and transmission-based contact and droplet precautions. After taking a history, including sexual and recent travel history, contact the CDPU on 1800 671 738 and press option 4 to speak to Clinical Nurse Consultant – Communicable Diseases to discuss testing.

• For other queries, contact the CDPU on 1800 671 738 (option 4).
• For mpox resources including guidance and procedures go to Mpox(monkeypox)resources on the Australian Government Department of Health and Aged Care
• Refer to Australian Immunisation Handbook on mpox 
• Refer to ATAGI interim statement on the use of vaccines for prevention of mpox

What is the concern for people travelling overseas?

On 14 August 2024, the World Health Organization declared the mpox outbreak in central and eastern Africa a public health emergency of international concern (PHEIC). 

Mpox is an infection caused by monkeypox virus. Infection mostly happens from direct skin to skin or sexual activity. 

The strain circulating in Africa appears to be more severe and spreads more easily than the strain currently circulating in Australia and globally. The virus is spreading from person-to-person through sexual contact, household contact, and within healthcare settings. 

For the most up to date international travel information, visit Smartraveller.gov.au

What should I do to protect myself while overseas?

If you are travelling to central or eastern Africa, or other areas affected by outbreaks, you should:

• avoid close contact with people who are sick or have rashes, lesions or sores
• stay away from infected materials used by people who are sick (such as clothing, bedding, towels, or materials used in healthcare settings)
• avoid contact with wild animals (alive or dead), such as rodents and non-human primates (monkeys, apes)
• avoid eating or preparing meat from wild animals (bushmeat) or using products made from wild animals (such as creams, powders or lotions) 
• wash your hands regularly.

If you are travelling elsewhere in the world, you should:

• visit www.smartraveller.gov.au for travel advice and outbreak information for your destination 
• exchange contact information with sexual partners
• avoid close contact with people who have mpox or mpox symptoms
• avoid contact with infected materials, such as bedding or towels
• wash your hands regularly.
• If you get symptoms of mpox such as a skin rash or lesions (sores) with or without fever and chills, you should:
  • seek medical care immediately and let them know that you may have symptoms of mpox
  • cover any exposed lesions (sores) with clothing or a bandage.

What should I do after I return to Australia?

If you have travelled to central or eastern Africa, you should monitor for symptoms for 21 days after leaving. 

If you get symptoms of mpox, you should follow advice as above, see What should I do if I develop symptoms? 

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